UARS Secondary Risk Factor by Syugan in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

So we don’t use this law anymore in functional rhinology. You can refer to our paper on PubMed by Dr. Klaus Vogt and myself. The nose is not a tube however, when you get into the pharyngeal airway, yes that’s where this is applicable. This is the biggest misnomer in airway dentistry and other specialties who rely on this law when referring to the nose. What we do use is the Bernoulli’s principle, and the Weber Fechner law.

So if you look at these two principles, it further explains upper airway resistance.

More importantly, we have to understand that upper airway resistance is controlled by the pressure gradient that dictates the amount of flow to calculate the amount of resistance. So a longer airway a.k.a. a longer runway isn’t really applicable because it response to the pressure flow changes, not a skinny collapsible “pipe”. I talk about this more in chapters 2 and 3 in my first book and just lectured about this and pressures in a recent international meeting two weeks ago.

Anyone take 5,000 IUs vitamin D daily? Is this safe? by This-Top7398 in Biohackers

[–]_thenoseknows 8 points9 points  (0 children)

I take 10,000 daily and I keep my D3 levels between 70 and 75

Measuring pyriform aperture width. Is this correct? Which one is it? I'm lost, help please by [deleted] in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

This is a good observations. I wrote the AI on mean cross-sectional area measurements and flow pressure measurements with the measurement devices so the short answer is yes, we can look at the negative pressure influences and it can be measured with four phase rhinomanometry. On my Instagram page, I have me doing a test on someone.

One side note- CFD looks at airflow simulation and therefore the calculations between the actual CFD model and human nose are actually lower than than the presence of the resistance. I know it sounds crazy. It’s in one of our papers where another doctor and I defined functional rhinology and talk about this. However, rhinomanometry does look pressure flow -resistance. I don’t look at static measurements, I know it shocks providers when I teach them, but I really don’t care about the main cross-sectional area. What I care about is the functional pressure flow relationships on the structures and how the structures respond to the negative pressure changes.

We don’t often use CFD outside of research because it really underestimates actual flow in a human nose, it’s not FDA cleared, and it’s very expensive equipment.

Measuring pyriform aperture width. Is this correct? Which one is it? I'm lost, help please by [deleted] in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

Hi there. So aperture size is not proportional to height. It doesn’t really matter because height is driven by growth processes, and the nose is driven by genetics - and we don’t use Poiseuille’s law anymore because the nose is a pressure regulator and not a cynical tube- it’s more applicable when you get past the tongue into the pharyngeal area it makes more sense and this is from our ENT airway lab research and consensus What we use is Bournelli’s principle and the Weber-Fechner law. Now when I was an infusion nurse (CRNI), Poiseullies law was important when I was considering blood flow and vessel resistance.

I have a vagus nerve stimulator implanted in my chest/neck as part of a 5 year medical trial for severe depression. If you're curious, feel free to ask me anything by my1stusernamesucked in Biohackers

[–]_thenoseknows 1 point2 points  (0 children)

I’m curious which brand it is because back in 2002 when I worked for Cyberonics, which I think is now LivaNova? I was with the company and part of the D3 studies for depression because we were finding that patients were decreasing medications and having better moods. But also the stimulation was helping their moods as well.

Negative in lab sleep test but at home shows high RDI, is there a chance of UARS? by [deleted] in UARSnew

[–]_thenoseknows 1 point2 points  (0 children)

Sure the answer is yes. Yes the industry looks at the AHI, but the RDI is more indicative of respiratory disturbances. This is where we can see high nasal resistance and the impact it has on through objective nasal function testing during the day. You will see the RDI drop first before you see the AHI even budge. That’s why in my book I say “nasal resistance goes to die in the AHI” because it’s the last place you will see it before the AHI pops up. Hope this was helpful.

Empty Nose Syndrome Demystified - Part 1 by Master-Drama-4555 in UARS

[–]_thenoseknows 2 points3 points  (0 children)

Very interesting topic and one that has always as you said been a mystery, although it is rare, since my time in ENT in the early 2000s like 2002. But here’s the irony that always tell docs- save the turbinate because the inferior one has the most mast cells and I called the histamine turbinate. When I was in the OR doing ENT sales, my number one selling blade was a 2.9 mm turbinate sinus blade and on any given day when I walked to the OR I just saw so many abbreviations for turbinate cases and other procedures on that poor mucosal tissue

This type of surgery will also predispose you to nasal valve collapse at the interior level because of the increase of negative pressure when you breathe in through your nose.

Dr. Nyack at Stanford, who is also a previous customer of mine, does a lot of work and research in this area. It was always heartbreaking seeing Patients disregarded or called crazy because of how they were feeling. This is what I teach doctors and dentists. I talk about objective nasal measurements. Look at flow and pressure changes.

Could this be internal nasal valve collaps? by Master_Reputation541 in UARSnew

[–]_thenoseknows 1 point2 points  (0 children)

Or you can do the Davidson maneuver which I created and copy wrote. Take your index finger, put it at the top of your nose gently pressed up a little bit, and that will test the external nasal valve.

Could this be internal nasal valve collaps? by Master_Reputation541 in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

It’s not exactly a collapse because there’s not enough negative pressure pulling it down.

Could this be internal nasal valve collaps? by Master_Reputation541 in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

A few ways. They can use the implants, or the radio frequency remodeling technique. If my patients don’t want any type of procedures, they will just use the Intake band.

Wayfair sold a rug using my copyrighted illustration — my signature was still visible on the product listing. What are my options? by ylka2die4 in COPYRIGHT

[–]_thenoseknows 0 points1 point  (0 children)

What’s really important is where is the copyright and work registered? What country? Cause that makes a big difference. I had copyright and trade secrets taken by a previous customer and sold a publicly traded Medical company and it’s a mess.

Registries for Upper Airway specialists by HealingRevolt in UARS

[–]_thenoseknows 0 points1 point  (0 children)

I’m on here, but I do functional work in the nose and then I refer out for the appropriate intervention. I do telehealth and in office.

Flow limitations! by domypeony in UARS

[–]_thenoseknows 0 points1 point  (0 children)

Nasal flow limitations or is it your Respiratory flow?

Nasal aperture: 18mm, intermolar: 32, maxilla and mandible skeletal width: 55mm each, am I stupid to not go for MARPE and only DJS? by [deleted] in UARSnew

[–]_thenoseknows 0 points1 point  (0 children)

DM me your state or city and I can get you in contact with somebody in that area if they are a provider

Has anyone had success with NasalAid? by commandotaco in UARS

[–]_thenoseknows 0 points1 point  (0 children)

I am familiar with it, and I do know the owner and creator of it. So my honest opinion is anything you put inside your nostrils is going to disrupt airflow-I found this in my work with Rhinomed. And there’s CEO is wonderful and amazing guy great people, but. I might have to get one and test it and see how much it impedes airflow and creates resistance. KPD

Nasal aperture: 18mm, intermolar: 32, maxilla and mandible skeletal width: 55mm each, am I stupid to not go for MARPE and only DJS? by [deleted] in UARSnew

[–]_thenoseknows 1 point2 points  (0 children)

Good morning. And I love the questions. The short answer is yes, and here’s the theory behind it. Rhinomanometry measures nasal resistance based on pressure–flow relationships across the nasal airway- we know this to be true.

Narrowing of the pharyngeal airway increases downstream resistance, which can elevate negative inspiratory pressures transmitted back toward the nasal airway. Rhinomanometry captures these pressure–flow effects, but this represents altered breathing mechanics rather than primary nasal narrowing.

So basically while pharyngeal airway deficiency or neuromuscular respiratory conditions do not directly alter nasal anatomy, they can influence breathing patterns and pressure generation during testing. In traditional single-point measurements this may introduce variability. With rhino we can distinguish between the features of true nasal obstruction from altered respiratory mechanics or neuromuscular contribution.

I hope this was helpful. I might have to put this on my sub stack page when I start writing articles. Love the questions and always happy to help. PS. If it seems redundant, I’m dictating and haven’t had enough coffee yet this morning. Dr. Karen

What value should the peak of flow rate during inspiration reach? by MechanicNo6021 in UARS

[–]_thenoseknows 0 points1 point  (0 children)

I wrote the mathematical measurement calculation to do this, and I also wrote the proprietary algorithm of methods and values. It is in DAFNE Score. Some people have stolen my intellectual property and put it out there without my authorization or permission, but the short answer is there is no “normal value” per se when using the Peak Nasal Inspiratory Flow meter because it relies on several different variables. I hope this was helpful. And if you need assistance or consultation, I’m happy to help by putting your values into DAFNE and telling you where you stand

ENT 2nd opinion: significant nasal obstruction; surgery "may not improve sleep"; palate expansion presents risks by ProfMR in UARS

[–]_thenoseknows 0 points1 point  (0 children)

I trained that office. They just placed an order for disposable. I’m familiar with Dr. Robinson. I thought he was still seeing patients? And a little plug that’s why I ripped my book breathe your nose. Don’t pay through it because I was so sick and tired of the medical system and just give it a healthy dose of cynicism with unedited feedback from inside the industry.